Foot Pain Accessory Navicular Bone

Overview
In an ideal situation, the navicular bone and the accessory bone will fuse together to form one bone. The problem that occurs is that sometimes the two bones do not fuse together and the patient is left with what is known as a fibrous union or basically a non solid union of bone to bone. This fibrous union is more like scar tissue and in theory can cause pain when excessive strain is placed upon it.



Causes
Let us see the reasons why the tendon or the bone would get aggravated. Ankle or foot sprain, irritation of the bone caused by footwear, overusing the foot, quite common in athletes and dancers. People born with this extra bone are also known develop flat feet which also adds to the strain on the posterior tibial tendon and lead to the syndrome.

Symptoms
It?s common for any symptoms to present during adolescence, when bones are maturing, though problems may not occur until adulthood. You may notice a bony prominence on the inner side of the midfoot. There may or may not be redness and swelling around this bump, especially if it rubs against footwear. You may be prone to blisters or sores in the area. Pain generally involves a vague ache or throbbing in the midfoot and arch as well, especially when you?re active. Many people with this syndrome develop flat feet, too, which can create additional strain in the foot.

Diagnosis
To diagnose accessory navicular syndrome, medical staff ask about the patient?s activities and symptoms. They will examine the foot for irritation or swelling. Medical staff evaluate the bone structure, muscle, joint motion, and the patient?s gait. X-rays can usually confirm the diagnosis. MRI or other imaging tests may be used to determine any irritation or damage to soft-tissue structures such as tendons or ligaments. Because navicular accessory bone irritation can lead to bunions, heel spurs and plantar fasciitis, it?s important to seek treatment.

Non Surgical Treatment
The goal of non-surgical treatment for accessory navicular syndrome is to relieve the symptoms. The following may be used. Immobilization. Placing the foot in a cast or removable walking boot allows the affected area to rest and decreases the inflammation. Ice. To reduce swelling, a bag of ice covered with a thin towel is applied to the affected area. Do not put ice directly on the skin. Oral nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may be prescribed. In some cases, oral or injected steroid medications may be used in combination with immobilization to reduce pain and inflammation. Physical therapy may be prescribed, including exercises and treatments to strengthen the muscles and decrease inflammation. The exercises may also help prevent recurrence of the symptoms. Custom orthotic devices that fit into the shoe provide support for the arch, and may play a role in preventing future symptoms. Even after successful treatment, the symptoms of accessory navicular syndrome sometimes reappear. When this happens, non-surgical approaches are usually repeated.



Surgical Treatment
If your pain and discomfort don’t go away with treatments like these, then it may be time to consider surgery. If you decide to go through with it, your surgeon will probably remove the accessory navicular once and for all, and will tighten up the posterior tibial tendon in order to make it better able to support your arch. You’ll probably have to wear a cast for a several weeks, and a brace for some months after that, but with patience, you may be able to say goodbye to your symptoms.